Medicare is built around those who provide care - doctors and nurses - not those who receive it. With an aging population, every Canadian hospital must move quickly to revolutionize its health services, with patients at the centre. If not, they should face a cut in public funds.

Most patients with multiple medical problems today are elderly; it is the price of a long life. But that cost should not include disjointed medical care, with numerous specialists in different locations and no one seemingly in charge. When these patients lack proper care, a medical crisis can hit, creating a logjam for hospitals, cancelled operations and wasted resources.

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Thousands of elderly patients sit in acute-care hospitals where they receive well-meaning but mishandled care: they are connected to machines of little benefit and prescribed drugs that worsen their cognitive function. They grow weaker, so the only solution seems a nursing home, which are often full. Only then do patients become the centre of something - a medical tragedy, not of their own making.

Some hospitals are working to fix the problem by merging with rehabilitation facilities. Others are creating a form of one-stop shopping, where health services are brought to patients.

More needs to be done. Failure to radically overhaul Canada's health-care system carries a risk of making medicare unaffordable for us all.